Individual
MR. KELLY EARL DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
539 6TH ST, PAWNEE, OK 74058-2542
(918) 762-3666
(918) 762-2288
Mailing address
539 6TH ST, PAWNEE, OK 74058-2542
(918) 762-3666
(918) 762-2288
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8992
OK
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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